This Tuesday, Massachusetts voters will decide whether to legalize assisted suicide, an agenda against which I have advocated energetically since 1993. During much of that time, I often asked myself the “why now?” question: Two hundred years ago, when far more people died in agony, few argued on behalf of mercy killing. Yet today—a time in which medical science can substantially alleviate most pain and end-of-life care works miracles of palliation—the notion that a “good death” comes from committing suicide resonates with large swaths of the public.
I could never get my head around the irony. But a few years ago a book written by the bioethicist Yuval Levin cleared up my confusion.
Early in Imagining the Future: Science and American Democracy, Levin writes, “Any society’s understanding of the foundational good necessarily gives shape to its politics, its social institutions and its sense of moral purpose and direction.” And what is our “primary good” in the West today? Not justice. Not even equality. It’s “relief and preservation—from disease and pain, from misery and necessity.”
Bingo! When eliminating suffering becomes the overriding purpose of a society, people can easily come to perceive that it is proper to accomplish the goal by eliminating the sufferer.
Levin doesn’t dwell on this in his book. But he returned to the question more fully in a recent essay in the New Atlantis, warning that we risk falling prey to the “dangerous temptation” of denigrating virtue, to the point, Nietzsche prophesied, it would eventually bring down liberal societies. Levin writes: “Unbalanced and unmoored from other goods, [health] can become a vessel for self-absorption and for decadence. It can cause us to abandon our commitment to our highest principles, and to mortgage the future to avert the present pain.”
I would take the argument even further: Elevating “health” to the ultimate purpose of society turns it into something other than health. The original definition of the term is elasticized to include a hedonistic sense of entitlement to obtain whatever our hearts desire. Health becomes understood as a prophylactic, if you will, against suffering. In such a milieu, ethics become transitory because we justify our behavior by feelings rather than robust principles of morality—which after all, sometimes require us to eschew what we want and what feels good in order to do what is right.
As just one example, many now assert a near-absolute right to procreate, which not only incorporates a license to destroy the gestating child we don’t want, but an ironic concomitant entitlement to a child with attributes we want via whatever means we deem most felicitous. In vitro baby-making has become a multi-billion dollar industry, serving not only married couples who can’t otherwise conceive, but also those who are not infertile or whose “infertility” is a natural part of aging or a constraint arising from sexual orientation.
Not only that, but in its drive to indulge customers’ desires, some in the industry pursue increasingly extreme measures. The doctor who implanted Nadya Suleman—infamously known as the “Octomom”—with multiple embryos is, perhaps, the most notorious example of acceding to reproductive extremism (for this, his California medical license was stripped).
Still, many once-radical approaches are becoming standard reproductive procedures: Brilliant and beautiful young college women receive $50,000 and more to risk their fecundity and health in egg harvesting. “Gestational carriers”—the dehumanizing term used in the IVF industry for surrogate mothers—bear children for infertile women and gay couples. In India, brokers offer well-off Westerners access to destitute women—two of whom recently died in the process—for their eggs and gestational capacities. Clinics in California offer sex selection. In these and other IVF practices—here and upcoming—we see Levin’s worry about the “dangerous temptation” playing out in real time.
I believe that promoting health is a laudable goal for a society. I also agree with the Declaration of Independence’s assertion of an inalienable right to engage in the pursuit of happiness. But Levin’s warning needs to be heeded: When we consider health to be the cake instead of the frosting, we approach the edge of a crumbling moral cliff.
Happily, we don’t have to invent the answer that can restore balance. Back in 1975, the ethicist Leon Kass focused his considerable intellect on this very problem, writing:
Fundamentally, it is not mere life, nor even a healthy life, but rather a good and worthy life for which we must aim . . . Indeed, though there is no such thing as being too healthy, there is such a thing as being too concerned about health. To be preoccupied with the body is to neglect the soul, for which we should indeed care “first and most.”
In other words, if we individually and collectively practice virtue—even when it means accepting suffering—we will make Nietzsche a false prophet by promoting health and pursuing happiness in the overarching context of protecting the equal moral worth of all human life.